Nomination Form

Dates

Nominations for the 2019 National Awards for Disability Leadership open on 16 June 2019 and close midday Friday 18 October 2019. .

Sign up to receive regular updates including information about nominations and the Awards ceremony.

Instructions

Complete all sections of the nomination form.

Ensure you have everything you need before you start, you cannot save this form.

You are required to submit a media quality photo of the nominee, this must be received prior to the close of nominations.

For nominations in the Arts Category please provide a 2 minute video showing the nominee’s work.

You are welcome to include two letters of support

If you are nominating a person for more than one category, complete a separate nomination form for each category

If your nominee requires support with communications or to participate in the Awards Ceremony please indicate this so we can ensure accessibility for all.

Eligibility

These Awards recognise the work of Australians. To be nominated you must be Australian, working in Australia, or specifically advancing the status of disabled Australians.

Nomination Form:

Nominations for 2019 open on 16 June 2019 and close midday 18 October 2019.

Sign up to receive the latest information about nominations and the Awards ceremony.

NationalAwardsNomination

Nomination form for National Awards for Disability Leadership

Name of nominee * Required

Who are you nominating?

Is the nominee a: * Required

Person with disability / disabled person

Disabled People's Organisation

A working group / collective of disabled people

A DPO is an organisation that has more than 50% of its members, board and staff disabled people with a leadership team made up of disabled people.

Nominee's organisation (if relevant):

Nominee's email address: * Required

Nominee's phone number: * Required

I have permission to nominate this person / organisation * Required

No

Yes

Please note that successful nominees and the recipient in each category will have their details made public on websites, through social media and promotional materials.

Your name * Required

Name of the person filling in this form.

Your organisation (if relevant):

Your contact email: * Required

Your contact phone number:

Assistance for nominee?

Please indicate if your nominee requires assistance to participate in the Awards, this may include with email, tech for the virtual awards ceremony, etc. We are aware that some disabled people use assistance to navigate processes, reading, technology and we wish to be inclusive. List the person who will provide assistance and their contact email and phone number.

Award category for this nomination * Required

You can only select one category per form, please use the whole form again if you wish to nominate the same person in another category as well.

The Arts - using artistic expression to advance the status of disabled people.

Innovation – being innovative, working outside the box, developing new systems, technology or tools to achieve outcomes in the status of disabled people.

Social Impact – using the public domain, through mainstream and social media, or other digital interfaces, to achieve visibility of disabled people.

Inclusion – designing processes, systems or programs which illustrate the diversity of disabled people as equal contributors to achieving outcomes.

Rights Activism – using human rights mechanisms, including implementing the Convention on the Rights of Persons with Disabilities, to advance the status of disabled people.

The Lesley Hall Award for Lifetime Achievement – awarded to an individual who has shown commitment to the disability rights movement and worked over time to achieve significant outcomes for disabled people.

Short bio * Required

Please provide a short bio of your nominee, this is what the MC will read out at the Awards Ceremony. (This field is character limited, keep your bio short.)

Why are you nominating this person or organisation for this Award? * Required

What outcome has the nominee achieved?
Please be mindful of the award definition and keep your nomination relevant to it.
Please also note how this nominee reflects the diversity of our community and how they work within, or address, intersectional factors. The information you include here is what the judges will use to make their decision.
Please don't write a book, tell us what the nominee has done to deserve this particular award.

Nominee photo

Accepted file types: jpg, png, gif.

Please provide a media quality photo of the nominee (usually 1MB) for distribution. Your nominee cannot be a finalist without this photo. You are welcome to provide it separately, however it must arrive prior to nominations closing.

Maximum file size - 4 mega bytes.

You are welcome to attach up to 2 letters of support for this nomination

Drop files here or

Accepted file types: doc, pdf.

The letters should be relevant to the award category from someone who knows the nominee's work well.

All arts finalists videos will be shown throughout the Awards Ceremony, so think about relevance and quality. THIS IS NOT AN AD, please respect that. If your video is too big to attach please send directly to engage@disabilityleaders.com.au